Fetal vascular adaptation before and after treatment of severe maternal anemia in pregnancy

Int J Gynaecol Obstet. 2016 Jun;133(3):284-6. doi: 10.1016/j.ijgo.2015.11.011. Epub 2016 Feb 17.

Abstract

Objectives: To use color Doppler ultrasonography indices to study the effects on fetal circulation of treating severe maternal anemia.

Methods: A prospective cohort study enrolled patients who were at 30-34weeks of pregnancy and had hemoglobin levels below 70g/L between November 1, 2011 and March 31, 2013 at a hospital in New Delhi, India. A control group consisting of patients with the same duration of pregnancy and with hemoglobin levels above 110g/L was included. Umbilical artery and middle cerebral artery velocimetry were performed using color Doppler ultrasonography at admission and after 4weeks and 6weeks of treatment.

Results: The maternal anemia cohort demonstrated a significantly lower middle cerebral artery resistance index and middle cerebral/umbilical artery resistance ratio (P<0.001) at admission. Following 4weeks of treatment for maternal anemia, significant increases in these parameters were observed (P<0.001).

Conclusion: Fetuses of individuals with severe maternal anemia demonstrated altered cerebral and umbilical artery flows. Normal flows were restored following treatment of maternal anemia.

Keywords: Cerebral/umbilical resistance ratio; Doppler velocimetry; Maternal anemia; Middle cerebral artery; Peak systolic velocity; Pulsatility index; Resistance index; Systolic/diastolic ratio; Umbilical artery.

MeSH terms

  • Anemia / epidemiology
  • Anemia / therapy*
  • Blood Flow Velocity
  • Case-Control Studies
  • Female
  • Fetus / blood supply*
  • Fetus / diagnostic imaging
  • Gestational Age
  • Hemoglobins / analysis
  • Humans
  • India
  • Middle Cerebral Artery / diagnostic imaging*
  • Parity
  • Pregnancy
  • Pregnancy Complications, Hematologic / epidemiology
  • Pregnancy Complications, Hematologic / therapy*
  • Prospective Studies
  • Severity of Illness Index
  • Ultrasonography, Doppler, Color
  • Umbilical Arteries / diagnostic imaging*

Substances

  • Hemoglobins